Characteristics of clopidogrel and the new antiplatelet agents prasugrel and ticagrelor ( 15 )
Characteristic | Clopidogrel | Prasugrel | Ticagrelor |
---|---|---|---|
Pharmacology | Thienopyridine drug; irreversibly inhibits P2Y 12 receptor | Thienopyridine drug; irreversibly inhibits P2Y 12 receptor | Non-thienopyridine drug; reversibly inhibits P2Y 12 receptor |
Metabolism | Prodrug; requires 2-step bioactivation via cytochrome P450 3A4 and 2C19 enzymes | Prodrug; requires 1-step bioactivation via cytochrome P450 2C19 enzyme | Direct-acting; active moiety |
Loading dose | 300–600 mg | 60 mg | 180 mg |
Maintainance dose | 75 mg/d | 10 mg/d (5 mg/d if age ≥ 75 yr or body weight ≤ 60 kg) | 90 mg twice daily |
When to stop before surgery | 5–7 d | 5–7 d | 5 d |
Avoid use in patients with: |
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